The echinocandins, including caspofungin, anidulafungin, and micafungin, act by inhibiting the β-1,3-glucan synthase that is necessary for fungal cell wall synthesis. These agents are considered fungicidal for Candida and fungistatic for Aspergillus.

• Among the safest antifungal agents, echinocandins offer broad-spectrum fungicidal activity against all Candida species, and caspofungin has been efficacious as salvage therapy for aspergillosis.
• If anidulafungin or micafungin is used in combination with cyclosporine, no dose adjustment is needed for either drug.